Tuesday, December 11, 2012

My husband and I made our third trip to L&D for preterm labor contractions. I was 37 weeks, 6 days along in my pregnancy. Upon our arrival, my contractions were irregular. My blood tests were normal, and I was only dilated 1 cm (same as the week before) and effaced 70%. The on-call doctor gave me three options, go home, receive some Morphine to ease the pain/discomfort of the contractions, or have a c-section. As my husband and I discussed the options, we initially opted for Morphine. As time went on, my contractions got more regular, and more painful. And Miley's heart rate spiked at 180bpm for 30 minutes, no explanation why. As the nurses brought in the morphine, I changed my mind and told them I would like some more time and to speak with the doctor again. I also asked them to call my OB because it felt like the three doctors we have seen over the course of my L&D visits had told us different things. I told my husband that I felt morphine would be just a temporary intervention, just like all the other medications that I had been prescribed over the course of the last 6 weeks trying to keep me comfortable and keep baby in, so we opted to not have morphine. Next, I asked the on-call doctor about the c section. We were all hesitate for me to go home as my contractions were becoming more regular and we were afraid I'd be back in L&D not long after I got home. I wanted reassurance that if I allowed the c section to occur that day that baby was "safe" and I would not be putting my baby in danger for selfish reasons (all my pain and discomfort). Little did I know how much I would regret this decision in just a few short hours.

As my c section began, my husband recorded the experience. We both were so very excited as Madison's birth was a wonderful experience for us. As my doctor began working, she said my uterus was so thinned out in one area, that Miley's head was definitely not in my pelvis where it should have been even though she was head down, and you could see right through it (they showed the nurses Miley's hair right through my uterus). It was this discovery that made my doctors and my family very thankful we opted for the c section that day, because the contractions I was having could have led to rupture of my uterus. And it also confirmed that I was not and would never be a candidate for a VBAC (if I can have anymore children).

Miley Ann was born Sunday, December 2nd 2012 at 1642 via c section. She was beautiful. 7 lbs 10 oz, 20 inches. But she (in my opinion) took longer than Madison to turn from blue to pink. After they cleaned Miley up, the nurse brought her over and laid her on my chest/neck for skin to skin while they finished closing my incision. I could believe how amazing it felt to hold my new little girl and how beautiful she was. After surgery my family and I went to recovery. Miley did breastfeed a little. As the nurses and my husband were doing her footprints, the nurse continually worried about Miley's coloring and grunting (when she breathed). They decided to try some manual CPAP treatment to help her oxygen levels/breathing rate. Shortly later, they told me they were taking Miley and my husband to the nursery to continue treatment. After 30 minutes of treatment, with little improvement, they contacted another hospital with a NICU, intubated my darling girl, and next thing I knew they were transferring her. My husband came in visibly crying, and the doctor came in to talk to me and let me know what was going on at which point I started to bawl. My husband and daughter were taken by ambulance to the NICU, and my dad and I followed in another ambulance a short time later.

The next several hours (including the ambulance ride) are a blur. The anesthetics had made me vomit multiple times that I received several different anti-nausea medications that made me sleepy and I couldn't keep my eyes open anymore. I awoke around 3am, 11 hours after my daughter was born. I was told I needed to pump my breasts as soon as possible to get my milk production going, and then I could go up to the NICU to see my daughter.

The next 4 days I spent being escorted in a wheelchair up to my daughter's room all day and night. We had to stay in separate rooms because I will still an inpatient recovering from surgery. We quickly established a routine without hesitation. And the hope was to take our sweet angel home the day I would be discharged from the hospital. I worked with lactation services, and continued to pump and breastfeed Miley. Meanwhile, a night nurse who was working with us kept insisting that it was my fault Miley was doing so poorly because I was not producing enough milk and that we should be bottle feeding her. She totally crushed my confidence as a mom that night, even though I showed her how much milk I was in fact producing. (8 ounces in a 5 minute pumping session, which is unheard of according to my other NICU nurses in the first 24 hours). I tried explaining my milk supply to this nurse, and how my first daughter only nursed 5-10 minutes on one breast per feeding because my supply was so excessive. The main issue with Miley was that after she latched, she could only suck 2-4 times before she started choking. So I tried pumping beforehand to take some of that milk load off with my letdown (which this same nurse also scolded me for, saying I was taking away milk from my baby). I tried multiple positions to help Miley not drown in milk, but it was apparent to me, as her mom, that she just simply couldn't remember to breath in between sucking. Much to my dismay and to please the nurse, we gave Miley a bottle of breastmilk, however, she did not want to latch onto it, and then had the same issue as she did with nursing. So the nurse proceeded to say, well I just can't believe that, I need to see it for myself, and proceeded to take my child and try to bottle feed her. It wasn't until then that this same nurse said, oh, she (Miley) is having a hard time with the suck, swallow and breath of eating.

Unfortunately during her NICU stay, she did not gain any weight, despite our weight counts before and after feeds showed she was getting milk. And currently, at 1 week 2 days old, Miley has still not gained any weight. In order to be discharged, Miley had to pass the 1 1/2 hour car seat test. They buckle her in the carseat and her oxygen saturation's and EKG are monitored and must maintain a certain level the entire test in order for her to be released. We had a few drops in her saturation's, but think it was due to placement of the monitor (which occurred anytime we lifted her out of her table crib, jostling of the cords). Although hesitant, the pediatrician released us under weight watch over the weekend. And sadly, as of Monday, Miley has not gained any weight. Our family pediatrician is giving us until Thursday for Miley to gain weight, and if we are not successful, she will have to be admitted and we will likely have to take her home with a feeding tube which means she will require around the clock care from her mama.

Meanwhile, we are waking (trying to anyway) Miley every 2-3 hours to eat. I try breastfeeding, which most times barely lasts 5 minutes before she doses off to sleep despite stripping her down and trying to stimulate her and using a wet, cool cloth. And then we are giving her a bottle, which takes 30 minutes to an hour to get her to drink. We're lucky if we can get her to drink 2 ounces from the bottle in one feed (plus whatever she gets from mommy).

I knew I'd have more confidence as a mom this time, and I am astounded by the bond my daughter and I have had since birth. It was apparent to me the first time I saw and held her in the NICU that she knew who I was. However, I am feeling horribly guilty and inadequate now as I watch my little girl struggle with each feed. And it breaks my heart to know she is not gaining any weight and there might not be much I can do without intervention. But we are hopeful.

UPDATE: Miley is 5 weeks tomorrow and is doing well now with weight gain! Thank goodness. We are about a pound OVER birth weight (she's breastfeeding great now!). However, my little love bug has a cold :-( She has lost her little voice, one of the saddest sounds ever, or lack thereof. Dr. said its not RSV so hopefully we can just keep nursing her back to health! Poor thing just cant catch a break.